| Entity Name: | PULMONARY AND SLEEP MEDICINE OF PALM BEACH PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 24 Jan 2019 (6 years ago) |
| Date of dissolution: | 12 Jun 2020 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 12 Jun 2020 (5 years ago) |
| Document Number: | L19000026344 |
| Address: | 2623 S Seacrest Blvd Ste 214 A, BOYNTON BEACH, FL, 33435, US |
| Mail Address: | 2623 S Seacrest Blvd Ste 214 A, BOYNTON BEACH, FL, 33435, US |
| ZIP code: | 33435 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972066876 | 2019-04-09 | 2019-04-09 | 2623 S SEACREST BLVD STE 214, BOYNTON BEACH, FL, 334357532, US | 2623 S SEACREST BLVD STE 214, BOYNTON BEACH, FL, 334357532, US | |||||||||||||||||||||
|
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| Phone | +1 561-602-3739 |
Authorized person
| Name | DR. FERNANDO KELLER |
| Role | PRESIDENT |
| Phone | 5616023739 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RS0012X - Sleep Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| KELLER FERNANDO | Agent | 6766 NEWPORT LAKE CIR, BOCA RATON, FL, 33496 |
| Name | Role | Address |
|---|---|---|
| KELLER FERNANDO | Authorized Member | 6766 NEWPORT LAKE CIR, BOCA RATON, FL, 33496 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-06-12 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-06-14 | 2623 S Seacrest Blvd Ste 214 A, BOYNTON BEACH, FL 33435 | No data |
| CHANGE OF MAILING ADDRESS | 2019-06-14 | 2623 S Seacrest Blvd Ste 214 A, BOYNTON BEACH, FL 33435 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2020-06-12 |
| Florida Limited Liability | 2019-01-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
